1989, 11-14 Permit App: 89004682 FurnaceJOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
CITY/STATE/ZIP:
OWNER:
436
X532- ("707
)5/ L.-7
val \ I1IL rki
iff ‘A724/72 -"PARCEL NUMBER:
a PHONE NUMBER: S '/ - c/75
MAILING ADDRESS:
CONTRACTOR:
MAILING ADDRESS:
(Street)
rr !
/ I s /l/, r Cr
(City/State) (Zip)
LICENSE NUMBER:5,y % 5 s /v
PHONE NUMBER: 3 % 5 /'/ 3 /
(Street)
7
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
Cr UNITS UNIT = AMOUNT
i1PSCRTPTTON
(Zip)
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU_
UNLISTED GAS APPLIANCE >400,000 BTU_
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x #.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00
x 10.00 =
!Hann =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/ 2 ".
4.".
NOTE:
SIGNATURE
MINIMUM PERMIT FEE IS $35.00
i//
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
$3
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$3�